Behavioural elements of professionalism: Assessment of a fundamental concept in medical care

Background: The Nijmegen Professionalism Scale, an instrument for assessing professional behaviour of general practitioner (GP) trainees, consists of four domains: professional behaviour towards patients, other professionals, society and oneself. The purpose of the instrument is to provide formative feedback. Aim: The aim of this study was to examine the psychometric properties of the Nijmegen Professionalism Scale. Methods: Both GP trainers and their GP trainees participated. Factor analysis was conducted for each domain. Factor structures of trainee and trainer groups were compared. Measure of congruence used was Tucker's phi. Cronbach's α was used to establish reliability. Results: Factor structures of the instrument used by GP trainers and trainees were similar. Two factors for each domain were found: domain 1, Respecting patient's interests and Professional distance; domain 2, Collaboration skills and Management skills; domain 3, Responsibility and Quality management; and domain 4, Reflection and learning and Dealing with emotions. Congruence measures were substantial (>0.90). Reliability ranged from 0.78 to 0.95. Conclusion: This study to validate the instrument represents one further step. To construct a sound validity argument, a much broader range of evidence is required. Nevertheless, this study shows that the Nijmegen Professionalism Scale is a reliable tool for assessing professional behaviour.